Prevalence and Antimicrobial Resistance of Bacterial Uropatho-gens Isolated from Iranian Kidney Transplant Recipients: A Systematic Review and Meta-Analysis

  • Abbas SHAPOURI MOGHADDAM Department of Immunology, BuAli Research Institute, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  • Maryam ARFAATABAR Department of Medical Laboratory Sciences, Kashan Branch, Islamic Azad University, Kashan, Iran
  • Jalil TAVAKOL AFSHARI Department of Immunology, BuAli Research Institute, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  • Ali SHAKERIMOGHADDAM 1. Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran 2. Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
  • Zahra MOHAMMADZAMANI 1. Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran 2. Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
  • Azad KHALEDI 1. Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran 2. Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
Keywords: Kidney transplant; Urinary tract infection; Iran

Abstract

Abstract

Background: Urinary tract infection (UTI) is a major complication in patients who receive the kidney transplant. We aimed to evaluate the prevalence and antimicrobial resistance of bacterial uropathogens isolated from Iranian kidney transplant recipients.

Methods: We searched according to Prisma protocol for UTI infection, prevalence, occurrence and distribution of bacteria and their pattern of antibiotic resistance among Iranian patients who receive kidney transplant through online electronic databases with MeSh terms and text words in published references in both Persian and English languages during 1990-2017. Data analysis was performed using Comprehensive meta-analysis software (CMA) by Cochrane Q and I2 Random Effects Model.

Results: Eleven studies met the eligible inclusion criteria. The prevalence of UTI among kidney transplant patients varied from 11.7% to 67.5%. The combined prevalence of UTI was 32.6%. Among Gram-negative pathogens causing UTI, E. coli was the most dominant followed by Klebsiella pneumonia with prevalence 41.3% and 11.9%, respectively. Also, amongst Gram-positive bacteria, the highest prevalence belonged to Enterococcus spp. (9.8%) and coagulase-negative Staphylococci (9.4%). Also in Gram-negative pathogens, the most resistance was to ampicillin (91.2%), followed by ceftazidime (89.5%).  The minimum resistance was against imipenem with prevalence 14.3%.

Conclusion: The combined prevalence of UTI was 32.6%. Gram-negative pathogens especially E. coli were the most agents of UTI in Iranian patients who receive kidney transplant. Also, in gram-negative pathogens, the most resistance was to ampicillin that it needs a new strategy for prophylaxis and treatment of UTI after the kidney transplant.

 

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Published
2019-12-02
How to Cite
1.
SHAPOURI MOGHADDAM A, ARFAATABAR M, TAVAKOL AFSHARI J, SHAKERIMOGHADDAM A, MOHAMMADZAMANI Z, KHALEDI A. Prevalence and Antimicrobial Resistance of Bacterial Uropatho-gens Isolated from Iranian Kidney Transplant Recipients: A Systematic Review and Meta-Analysis. Iran J Public Health. 48(12):2165-2176.
Section
Review Article(s)